• Alba Vila-Casademunt, Ferran Pellisé, Emre Acaroglu, Francisco Javier Sánchez Pérez-Grueso, Mar Pérez Martín-Buitrago, Tunay Sanli, Sule Yakici, Ana García de Frutos, Antonia Matamalas, José Miguel Sánchez-Márquez, Ibrahim Obeid, Onur Yaman, Juan Bagó, and ESSG, European Spine Study Group.
• *Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain †Spine Surgery Unit, Hospital Vall d'Hebron, Barcelona, Spain ‡Spine Surgery Unit, Ankara Spine Center, Ankara, Turkey §Spine Surgery Unit, Hospital Universitario La Paz, Madrid, Spain ¶Spine Surgery Unit, Florence Nightingale Hastanesi, Istanbul, Turkey; and ‖Spine Surgery Unit, Bordeaux University Hospital, Bordeaux, France.
• Spine. 2015 Feb 15; 40 (4): E253-8.

Study DesignSagittal pelvic parameters (SPPs) of a representative patient sample drawn from a consecutive adult spinal deformity database were measured using Surgimap Spine. Estimated coefficient of reliability intraclass coefficient (95% confidence interval), standard error of measurement, and mean absolute deviation were used for the analysis.ObjectiveThe primary objective of this study was to assess the reliability of SPP measurements using Surgimap Spine. The secondary objective was to evaluate the impact of pelvic instrumentation as well as the impact of user expertise.Summary Of Background DataThe radiographical measurement of SPP is increasingly recognized as playing a critical role in establishing the surgical goals and surgical strategy of many spinal disorders. Although instrumented flatback is a common cause of sagittal malalignment, to our knowledge, SPP measurement reliability has never been assessed in instrumented spines.MethodsSixty-three adult full-spine standing lateral radiographs (31 with lumbosacral instrumentation) were measured twice by 13 observers using Surgimap Spine. Observers were stratified into 3 levels of experience: high (research coordinators, 4), mid (senior surgeons, 5), and low (junior surgeons, 4). Research coordinators trained all surgeons for less than 30 minutes. Parameters measured were pelvic incidence, pelvic tilt, and sacral slope.ResultsThirteen observers and 63 radiographs generated 817 observations (2 misses). Overall inter- and intraobserver reliability of SPP measurement was excellent (intraclass coefficient > 0.85). Lumbosacral instrumentation did not modify intraobserver reliability but reduced significantly interobserver reliability of pelvic tilt (P = 0.006) and sacral slope (P = 0.007). Experience did not affect intraobserver reliability but interobserver reliability of highly experienced observers was significantly lower (P < 0.05) than among less experienced observers.ConclusionMeasurement of SPP using Surgimap Spine equals or improves previously reported reliability data. Lumbosacral instrumentation reduces interobserver reliability taking it from excellent to moderate in the sacral slope measurement. Inexperienced observers can measure SPP reliably after a short tutorial.Level Of Evidence4.

21 keywords...

hide…